What is a Passy-Muir® Valve? (2024)

Invented by a patient named David Muir, the Passy-Muir®Valve is a simple medical device used by tracheostomy and ventilator patients. When placed on the hub of the tracheostomy tube or in-line with the ventilator circuit, the Passy-Muir Valve redirects air flow through the vocal folds, mouth and nose enabling voice and improved communication. Years of evidence-based research has shown that the Passy-Muir Valve offers patients numerous clinical benefits beyond communication, including improved swallowing, secretion management, and oxygenation.

Why use a Passy-Muir Valve?

"No Leak" Design
The patented "No Leak" design of the Passy-Muir® Valves means that the valve is always in a closed position until the patient inhales. The valve opens easily with less than normal inspiratory pressures and closes automatically at the end of the inspiratory cycle without air leak and without patient expiratory effort.

Closed System
Unlike open position speaking valves, the closed position of the Passy-Muir Valve allows the patient to create a positive airway pressure and restores the patient to a more normal "closed respiratory system". The "closed system" also creates a protective column of air in the tracheostomy tube which resists secretions from moving up the tube and occluding the valve. Instead, secretions may be coughed up around the tube and expectorated or suctioned from the mouth.

What is a Passy-Muir® Valve? (1)All Passy-Muir Valves have a closed position "No Leak" design that restores a closed respiratory system.
What is a Passy-Muir® Valve? (2)"No Leak" design maintains a column of air in the tracheostomy tube and redirects airflow and secretions up the trachea.
What is a Passy-Muir® Valve? (3)All other speaking valves have an open position design that causes air leakage during exhalation.

Clinical Benefits



The Passy-Muir® Valves are the only speaking valves that have been research validated for all of the following benefits:

    • Restores Positive Airway Pressure:Due to the closed position"No Leak"design of the Passy-Muir Valves and the more normal closed respiratory system it creates, positive airway pressure is restored. This in turn promotes louder voice, improved swallow, stronger cough, and increased oxygenation.
    • Superior Voice/Speech Production:Patients can produce clearer voice with more normal phrasing, better vocal quality and increased volume because all exhaled airflow is redirected up past the vocal cords.
    • Improves Swallow & May Reduce Aspiration:The closed position"No Leak"design of the Passy-Muir Valves restores the patient to more normal physiology. This design facilitates increased pharyngeal/ laryngeal sensation and restores subglottic air pressures which improves swallow and may reduce aspiration.
      • Restores Subglottic Pressure
        Only the closed position "No Leak" design of the Passy-Muir Valve reestablishes a closed respiratory system and restores subglottic pressure, which improves swallowing and may reduce aspiration.
What is a Passy-Muir® Valve? (4)

Video Fluoroscopy without Passy-Muir® Valve: Aspiration

What is a Passy-Muir® Valve? (5)

Video Fluoroscopy with Passy-Muir® Valve: No Aspiration


FEES study, by Liza Blumenfeld, MS, CCC-SLP, Scripps Memorial Hospital, La Jolla, CA
    • In-Line Ventilator Use:Adult, pediatric and neonatal ventilator dependent patients can utilize the Passy-Muir Valve during mechanical ventilation. All Passy-Muir Valves are interchangeable and can be used both on or off acute care and portable ventilators.

  • Expedites Weaning:The Passy-Muir Valves are used as an augmentative tool for weaning patients from the ventilator as it reestablishes physiologic PEEP, which in turn may improve oxygenation. As the patient becomes accustomed to exhaling through the upper airway, patient confidence is improved and respiratory muscle retraining is facilitated.
  • Reduces Decannulation Time:The Passy-Muir Valves can be utilized as an interim step in the decannulation process by allowing the patient to begin to adjust to a more normal breathing pattern through the upper airway on exhalation. This allows the patient to gain confidence and the physician to assess for airway patency and can significantly shorten the decannulation process.
  • Improves Oxygenation:The closed position"No Leak" designof the Passy-Muir Valves restores a more normal closed respiratory system. As a result, Positive End Expiratory Pressure (PEEP) is reestablished which facilitates improved oxygenation.
  • Improves Olfaction:The Passy-Muir Valves improve the sense of smell by reestablishing airflow through the oral/nasal cavities during exhalation. This improved sense of smell may lead to an increase in sense of taste, appetite, and caloric intake which is important in the recovery process.
  • Facilitates Secretion Management:The Passy-Muir Valve design improves swallowing and facilitates a stronger, more effective cough with oral expectoration of secretions. Evaporation of secretions occurs due to redirection of air through the upper airway during exhalation. May reduce suctioning needs and associated costs by restoring function of the bronchial hygiene system.
  • Facilitates Infection Control:The Passy-Muir Valve eliminates the need for finger occlusion of the tracheostomy tube which can lead to infections and offers protection from particulates entering the trachea. The Passy-Muir Valves redirect secretions through the upper airway allowing oral expectoration and reducing contamination of the patient's immediate environment.
  • Interchangeability Between Tracheostomy and Ventilator Use:All Passy-Muir Valves can be used both on and off the ventilator with both pediatric and adult patients. This includes non-ventilator dependent tracheostomized patients, patients who are weaning from the ventilator and patients who are ventilator dependent. The Passy-Muir Valves can be placed in-line with the ventilator using disposable tubing (withPMV® 007only) or non-disposable flexible rubber tubing (withPMV® 005,PMV® 007,PMV® 2000andPMV® 2001).
What is a Passy-Muir® Valve? (2024)

FAQs

What is a Passy-Muir® Valve? ›

The Passy Muir® Valve is the only bias-closed position valve that can be used during MV. The Passy Muir Valve opens during inspiration and closes at the end of inspiration, re-directing exhalation through the vocal cords and out through the mouth and nose, which allows for verbal communication.

What is the purpose of a Passy Muir valve? ›

In addition to voice and speech production, Passy Muir Valves improve swallow, secretion management, and the sense of smell and taste. The Valves may reduce aspiration and assist with infection control, ventilator weaning, and decannulation.

When not to use a Passy Muir valve? ›

Purpose: To establish a safe and standardized procedure for the placement of a Passy Muir Valve (PMV®) on an adult tracheostomy tube or ventilator patient. Absolute Contraindications: Severe upper airway obstruction, medical instability, foam-cuffed trach tube.

What is the difference between a speaking valve and a trach? ›

Takeaway. A speaking valve is a one-way valve that blocks your tracheostomy when you exhale. Blocking your tracheostomy allows air to pass through your vocal cords and can help you speak. A speaking valve can also potentially improve the quality of your swallowing and may improve your sense of smell and taste.

What is the Passy Muir valve used for on a ventilator? ›

Clinical Research Demonstrates Early Use of the Passy Muir® Valve, including ventilator application, can expedite ventilator weaning. The use of the Passy Muir Valve in mechanically ventilated patients facilitates independent vocalization, allowing them to become active participants in their healthcare.

Can a patient sleep with a Passy Muir valve? ›

The PMV is formally indicated for wake time use only; however, beneficial effects may be hastened if patients were also permitted to sleep with the PMV in place. To date, the use during sleep has not been reported.

What causes a Passy Muir valve to pop off? ›

This is because the air being exhaled is now going through the throat, instead of out of the tracheostomy tube, and they are feeling secretions that are in the throat. Sometimes they will cough hard enough that the Valve will pop off the tracheostomy tube.

Who is not a candidate for Passy-Muir valve? ›

Patient exclusion criteria / contraindications:

- Unstable respiratory/cardiac status, high therapeutic PEEP - History of tracheal stenosis, obstructing lesions or anatomical abnormalities, which may impact upon upper airway patency. These patients should consult otolaryngology.

Does Passy-Muir improve oxygenation? ›

May Improve Oxygenation

The bias-closed position, no-leak design of the Passy Muir Valves restores a more normal closed respiratory system. As a result, Positive End Expiratory Pressure (PEEP) is reestablished which may facilitate improved oxygenation.

Can trach patients drink water? ›

Eating and drinking

You may be able to eat and drink with a tracheostomy. But if you cannot swallow, you may need to have a thin feeding tube inserted through your nose and down into your stomach. This allows liquid food and fluids to be given to you directly.

Why can't tracheostomy patients talk? ›

If the cuff is inflated (filled with air), it will prevent air from moving through your vocal cords. This will stop you from making noise or speech. If the cuff is deflated, the air is able to move around the trach and through your vocal cords, and you should be able to make sounds.

Can you speak without a speaking valve for tracheostomy? ›

You might be able to make your voice work by covering the trach tube opening with your finger, or you may be able to use a speaking valve to help you talk. A speaking valve is a special attachment designed to help you speak with a trach, but not all trachs allow for this attachment.

Can you eat with a speaking valve? ›

If you have a speaking valve, you may use it while you eat. It will make it easier to swallow. Suction the tracheostomy tube before eating. This will keep you from coughing while eating, which could make you throw up.

How long can you wear a Passy-Muir valve? ›

The PMV should last at least two months if you care for it properly. If the PMV becomes sticky, noisy or vibrates during use, it is time to replace it. Need suctioning – Remove the PMV and suction/ cough as needed. The cuff is not deflated completely – Immediately remove the PMV and deflate the cuff completely.

What is the primary purpose of the Passy-Muir? ›

Facilitates Secretion Management: The Passy-Muir Valve design improves swallowing and facilitates a stronger, more effective cough with oral expectoration of secretions. Evaporation of secretions occurs due to redirection of air through the upper airway during exhalation.

Can you talk with a Passy-Muir valve? ›

The Passy Muir® Valve is the only bias-closed position valve that can be used during MV. The Passy Muir Valve opens during inspiration and closes at the end of inspiration, re-directing exhalation through the vocal cords and out through the mouth and nose, which allows for verbal communication.

What is the primary benefit of using a speaking valve? ›

The use of a speaking valve can assist with the restoration of the flow of air through the vocal cords and upper airway. The benefits of a speaking valve include, but are not limited to, improved voicing, improved taste/smell, improved swallowing and improved secretion management.

Does the Passy Muir valve improve oxygenation? ›

Invented by a patient for patients, the Passy Muir Valve restores communication, improves swallowing and oxygenation, and expedites weaning and decannulation. The Valve may be used interchangeably on or off the ventilator for both pediatrics and adults.

What is the purpose of the one-way speaking valve? ›

A one-way valve is a plastic attachment that fits on to the end of your child's tracheostomy tube. The valve opens to allow your child to breathe in through the tracheostomy tube. When they breathe out the valve closes. This diverts the air up through the voice box, throat and mouth/nose as in normal speech.

When should I start my Passy Muir valve? ›

Assessment Criteria for Use of the Passy Muir Valve:

Medically stable: PMV will be initiated within 72 hours of admission and pending MD order. 2. Ability to tolerate cuff deflation: Allows air to pass around the trach tube.

References

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